ALLCASES KARTIKA 2

FEBRUARY 14TH 2016

1

Mudorih/M/14
yo
BW : 42 kg

ALL on high risk

Induction phase, week 1th

Hb: 7.8 mg/dL

Leukocyte: 1.210/uL
AT: 123,000/uL
ANC: 720/uL

PRC transfusion

Maulana/M/15
yo
BW : 15 kg

AML
Vulnus Granulosum on
scrotum
Severly malnourished

Leucocain 300mg/24 hours

Wound care

Siska/F/ 2.5 yo
BW : 7.6 kg

Intra abdominal mass susp

Hypothyroidism susp
Anemia normocyticnormochromic
Severely malnourished

Hb: 9.6 mg/dL

Leukocyte: 410 /uL
AT: 67,000/uL
ANC: 130/uL
Albumin 3.45 gr/dL
Hb: 7.2 mg/dL
Leukocyte: 17.700/uL
AT: 296,000/uL
ANC: 11.150/uL

Naila/F/ 1.5 yo
BW : 10 kg

Nephroblastoma in week
26th chemotherapy

Vincristin

Bayu/M/ 6 yo
BW : 12 kg

AML
Neutropenia Fever
Common cold

Viska/F/6 yo
BW : 19 kg

ALL HR induction phase

week 0
Hyperleucocytosis
Febrile neutropenia

Lintang/M/10
yo
BW : 45 kg

Rhabdomyosarcoma on 5th
week chemotherapy
Stenosis renal artery
Hypertension stage I

Hb: 11.6mg/dL
Leukocyte: 10,450
/uL
AT: 79,000/uL
ANC: 3,960/uL
Hb: 10.8 mg/dL
Leukocyte: 6240/uL
AT: 32.600/uL
ANC: 410/uL
Pct: 0.25
Hb: 7.3 mg/dL
Leukocyte:
347.800/uL
AT: 28,000/uL
ANC: -/uL
Hb: 11.3mg/dL
Leukocyte: 12910/uL
AT:22,000/uL
ANC: 11000/uL

Past medical history

Hiperleucositosis

PRC transfusion
6th day Cefotaxime
Pro biopsy

2th day Ampicillin + Ciprofloxacin

Salbutamol 1mg/8 hours

Hyperhydration management
Pro Methothrexate intratechal on
Monday
Pro TACI embolization
Morphine per oral

Severely malnourished
ALL
Neutropenia Fever
Acute Rhinofaringitis
Stomatitis
ALL high risk relaps
Epilepsi on therapy
Neutropenia Fever
Gum bleeding ec
Trombositopenia

Laras /F/ 9 yo
BW : 27kg

Ilham/M/16 yo
BW : 45 kg

10

Amanudin/M/13
yo
BW : 45kg

ALL dd AML
SIRS
Tumor Lysis Syndrome
Gum bleeding ec
trombocytopenia

11

Novita/F/14 yo
BW : 45 kg

12

Soluna/F/ 8 yo
BW : 23 kg

Embryonal
rhabdomyosarcoma susp.
Sepsis
Neutropenia Fever
Selulitis r.mandibula
Normocytic normochromic
anemia
Hipoalbuminemia
Hiponatremia
ALL high risk on therapy 2nd
week
Vomitus Profuse

13

Alvinko/M/3 yo
BW : 12 kg

ALL standard risk on

chemotherapy induction
phase 3th week

Hb: 10.4mg/dL
Leukocyte: 3530 /uL
AT: 257,000/uL
ANC: 340/uL
Hb: 7.3 mg/dL
Leukocyte: 9060/uL
AT: 34,000/uL
ANC: -/uL

2 nd day ampicilin+ciprofloxacin
Salbutamol 2mg/8 hours

Hb: 9.8 mg/dL

Leukocyte: 4070/uL
AT: 31,000/uL
ANC: 310/uL
BUN: 41.9
Creat:3.58
Na: 132
K: 2.4
Cl: 101
Hb: 5.4mg/dL
Leukocyte: 600/uL
AT: 25,000/uL
ANC: 150/uL
Alb: 1.84

Hypehidration Management
Transfusion Trombocyt and PRC

Hb:8.5mg/dL
Leukocyte: 2480/uL
AT: 69,000/uL
ANC: 200/uL
Hb: 10.4 mg/dL
Leukocyte: 2,110/uL
AT: 215,000/uL
ANC: 310/uL

Ondansentron
Cancer pain if pain

3 th day ceftazidim+gentamycin
3 th day fluconazole
Phenitoin 20mg/12 hours
PRC transfusion

Transfusion PRC
3th day ceftriaxon and
metronidazole
3th day Leucocin

Chemotherapy

14

Elfin/M/ 12 yo
BW : 26 kg

NPC
Severe headache

Hb: 12.7 mg/dL

Leukocyte: 17,630/uL
AT: 365,000/uL
ANC: /uL

5FU

15

Ignasius/M/ 11
yo
BW : 37kg

ALL HR on consolidation
phase 12th week

Hb: 10.6 mg/dL

Leukocyte: 1550/uL
AT: 363,000/uL
ANC:630/uL

Methotrexate intratechal on Monday

16

Irfan/M/ 10 yo
BW : 28 kg

Febrile neutropenia
Severe anemia
AML-M4

Hb: 10.4 mg/dL

Leukocyte: 14.410/uL
AT: 432,000/uL
ANC: 9130/uL

Post leucocain

ALLCASES KARTIKA 1A
February 14th 2016
VIP
1

Narendra/ M/
12yo/
BW: 50kg

VIP
2
ISO
3

M.Nir/ M/ 6yo
BW: 16kg

Nazanin/ F/ 6 mo
BW: 6.5 kg

Primary
mediastinum germ
cell tumor on 6th
cycle (19th week)
Stomatitis

Septic shock overcome

Sepsis
Thypilithis
T cell lymphoma
DIC
Pneumonia susp
ALL HR consolidation
phase week 8th
Stage II HT

Hb : 8.1
AL : 13,900
AT : 310,000
ANC : 10,990

Mon GA/VS/FB/SE drugs

Inj. Cefotaxime 1 gr/12h
Inj. Metronidazole 500mg/8h
Inj. Novalgin 500 mg/8 jam
Waiting for biopsy of hepar (result)
(January 28, 16)

Hb : 7,4
AL : 3.930
AT : 1.000
ANC : 3.830
Hb : 12,9
AL : 8990
AT : 22.000

Mon GA/VS/bleeding
Inj. Meropenem
Inj.fluconazole
Inj. Metronidazole
Inj. Amikacin
Management DIC
Mon GA/VS/FB
Cotrimoxasole
Cyprofloxacin

Prolonged diarrhea
Sepsis
PCP
Chronic ITP

5A

Zufa/male/ 5
years old, BW: 18

5B

Rafli, male, 10
years old, BW: 20
kg

6A

syafik/ M/ 3 yo
BW:25kg

6B

M. Aji/ M/ 15yo
BW: 42 kg

NHL cell B cycle 5 week 13

Jacinda/ F/ 1yo
BW: 9yo

8A

Wahyu, male, 5
years old, BW: 12
kg

ALL HR induction phase

week 5th
HFMD
Acute watery diarrhea
hystiocitosis
Asthma

8B

Arya, male, 5
years old, BW: 16
kg

AML relaps on
chemoteheraoy week 5th
acute pharyngitis
acute diarrhea without
dehydration
thypilitis susp.
Subconjungtival bleeding

9A

Khamdan, male,

Septic shock overcome

Superior vena cava

syndrome
Anterior mediastinum
mass cb lymphoma susp.
Dd thymoma susp.
Pleural efussion
Iron defisiensi anemia
susp.
ALL HR maintenance
phase week 42
Febrile neutropenia

ANC : 7260

Bisoprolol, valsartan, amlodipin

Hb : 12.1
AL : 9400
AT : 18000
Hb : 10,2
AL : 4640
AT : 162.000
ANC : 3010

Mon GA/VS/FB
Inj. Methylprednisolone

Hb : 12.3
AL : 460
AT : 4000
ANC : 50
Hb : 8.6
AL : 8910
AT : 23000
ANC : 2300
Hb : 12.9
AL : 2400
AT : 135.000
ANC : 1740
Hb : 10.4
AL : 73.500
AT : 45.000
ANC : 19.920
Hb : 8.5
AL : 1520
AT : 24000
ANC : 340

Mon GA/VS/FB/SE Drugs

Ciprofloxasin
Pro chemotherapy
(MTX-IT)
Mon GA/VS/FB/SE Drugs
Inj. Meropenem

Hb : 7,9

Mon GA/VS/FB/SE Drugs/Bleeding

Mon GA/VS/FB/SE Drugs/ Pain

O2 1 liter per minute
Establish diagnosis (bronchoscopy
and thorax ct scan)

Mon GA/VS/FB/SE Drugs

Inj. Ceftriaxone
metronidazole
Mon GA/VS/FB/WOB
Inj. Ampicillin
Inj. Cyprocloxacin
Nebulizer salbutamol
Mon GA/VS/FB/SE Drugs
Inj. imipenem
Metronodazole
Zinc
No chemotherapy based on AML
protocol (week 6th-8th)

6 months old,
BW: 35 kg

Bacterial
meningoencephalitis
Preleukemic stage
Aspiration pneumonia
Sepsis
Febrile netropenia
Recurrent hyponatremia

AL : 300
AT : 1.000
ANC : 50
SGOT : 286
SGPT : 101

Inj. Meropenem
Cotrimoxazole
During correction of hyponatremia
with NaCl 3%
Phenobarbital
Phenitoin

Estella 2 Ward
January 31st 2016

No

Name

Diyas, M, 7
yo

BW :22 kg

Diagnosis

AML relaps
History of histiocytosis
Stomatitis
Febrile neutropenia
Petechie cb thrombocytopenia
Acute watery diarrhea

Laboratory

Jan 27th 2016

HB : 11 g/dL

Problem and Planning

Pro chemotherapy session : Cytarabine iv

and L-aspar iv (1/2/16)

AL : 3,760 /mm3
Platelet : 46,000
/mm3
ANC : 310

2.

Husna, F,
7yo

ALL dd AML susp

DF : Compensatio cordis
DE : Acyanotic CHD

Jan 28th 2016

Waiting for result of BMP

 DA : Small PDA

HB : 9 g/dL
AL : 3,660 /mm3

BW 15 kg

Platelet : 12,000
/mm3
ANC : 2,770

3.

Yunita, F, 10
yo

AML on palliative care

ICH frontoparietooccipital dextra
Decompensatio cordis ec Anemia
gravis

BW 25 kg

Jan 29th, 2016

HB : 5.7 g/dL

Platelet transfusion 6 kolf/12 hours

Dexamethasone iv 5mg/8hours

WBC :
17,480/mm3
Platelet :
21,000/mm3
ANC : 14,810

4.

Lintang, M,
12 yo

BW 35 kg

Rhabdomyosarcoma on
chemotherapy
Controlled hypertczension
A. renalis stenosis
Sepsis
Severe malnutrition marasmickwashiorkor type

Jan 30th, 2016

HB : 13.5 g/dL
WBC :
5,180/mm3
Platelet :
370,000/mm3
ANC :
BUN : 11,1

Amlodipine 5 mg/24 hours

Bisoprolol 2,5 mg/24 hours
MST 5 mg/ 8 hours
Abdomen CT Angiography (1/2)

Creatinin : 0,34

5.

Hilya, F, 2 yo

Retinoblastoma on chemo
Acute Pharyngitis

BW: 8 kg

Jan 29th, 2016

Pro MTX IT (1/2)

HB : 10.8 g/dL
WBC : 10,340
/mm3
Platelet :
192,000/mm3
ANC : 14,810

6.

Fauzan, M, 6
yo

Pansitopenia dd ALL relaps

Febrile Neutropenia
Sellulitis cruris sinistra

Jan 28th ,2016

Antibiotic : Ceftriaxone (4th day)

HB : 9.9 g/dL
WBC : 1,360
/mm3

BW: 54 kg

Platelet 20,000
ANC 160

7.

Maulana, M,
15yo

AML on chemotherapy 3rd week

Drug erruption susp
Febrile netropenia

Jan 31 rd 2016
HB : 9.3 g/dL
AL : 350 /mm3
Platelet : 25,000

Leucokin
Ceftazidim + Gentamycin (5th day)
Ketokonzaole per oral

/mm3

BW 30 kg

ANC : 130
8.

Ilyas, M, 3,5
yo

ITP

Jan 30th , 2016

HB : 12.9 g/dL

Methylprednisolone 35mg/8hours (2nd

day)

WBC :
13,940/mm3

BW 14 kg

Platelet :
5,000/mm3
ANC :
9.

Khaerul, M,
16 yo

BW 38 kg

ALL-HR induction phase

Jan 29th , 2016

HB : 9.5 g/dL
WBC :
3,390/mm3
Platelet :
181000/mm3
ANC : 2,840

Paracetamol (if needed)